关键词: 麻醉深度指数, 老年创伤骨科, 血清S100β蛋白水平, 术后认知功能障碍

Abstract:

Objective： To study the correlation of cerebral state index （CSI） regulation on serum S100β protein level and postoperative cognitive dysfunction （POCD） in elderly patients undergoing orthopedic trauma surgery.Methods： 100 elderly patients underwent traumatic orthopedic surgery in our hospital from September 2022 to September 2024 were selected as the research objects and randomly divided into the high CSI group （CSI maintained at 60-70， n=50） and the low CSI group （CSI maintained at 40-50， n=50）. The anesthesia time， postoperative recovery time， recovery time of orientation， anesthetic dosage， mean arterial pressure （MAP）， heart rate （HR）， serum S100β protein （S100β） and mini-mental state examination （MMSE） were compared between the two groups， and the correlation between CSI level and S100β and POCD was analyzed by Spearman's correlation.Results： There was no significant difference in the postoperative recovery time， orientation recovery time， and anesthetic dosage between the two groups （P>0.05）. Compared with the low CSI group， the anesthesia time in the high CSI group was significantly lower （P<0.05）. There was no significant difference in the HR and MAP levels before anesthesia， after 30 min of anesthesia， and at the end of surgery between the two groups （P>0.05）. Comparing S100β levels after 30 min of anesthesia and at the end of surgery， the high CSI group was significantly lower than the low CSI group （P<0.05）. Compared with one day before operation， the MMSE score of the two groups decreased on the seventh day after operation， and the high CSI group was higher than the low CSI group. Compared with the low CSI group， the high CSI group significantly increased the CSI and decreased the incidence of POCD （P<0.05）. After correlation analysis， CSI level was significantly negatively correlated with S100β and POCD， both （P<0.05）.Conclusion： Keeping the CSI index in the range of 60-70 has a positive impact on the perioperative indexes of elderly trauma orthopedic surgery patients， which helps to maintain the hemodynamic steady state and effectively reduces the S100β protein level and the risk of postoperative POCD. In addition， there is a significant negative correlation between CSI index and S100β protein level and the incidence of POCD， which should be highly concerned in clinical treatment.

Key words: Cerebral state Index； , Geriatric trauma orthopedics； , Serum S100β protein level； , Postoperative cognitive dysfunction